ارتباط بی‌احترامی و بدرفتاری حین زایمان با افسردگی پس از زایمان در مادران مراجعه‌کننده به مراکز جامع سلامت شهر سقز در سال 1402

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد مامایی، کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.

2 مربی گروه مامایی، مرکز تحقیقات مراقبت بالینی، پژوهشکده توسعه سلامت، دانشگاه علوم پزشکی کردستان، سنندج، ایران.

3 استاد گروه مامایی، مرکز تحقیقات مراقبت بالینی، پژوهشکده توسعه سلامت، دانشگاه علوم پزشکی کردستان، سنندج، ایران.

10.22038/ijogi.2025.84485.6286

چکیده

مقدمه: شناسایی عوامل­ خطر بروز اختلالات روانی بعد از زایمان نظیر افسردگی، با توجه به اهمیت و عوارض آن، گامی در جهت ارتقای سطح سلامت مادران است، بنابراین مطالعه حاضر با هدف تعیین ارتباط بی‌احترامی و بدرفتاری حین زایمان با افسردگی پس از زایمان انجام شد.
روش‌کار: این مطالعه مقطعی در سال 1402 بر روی 348 نفر از مادران واجد شرایط مراجعه‌کننده به مراکز جامع سلامت شهر سقز که به‌صورت خوشه ­ای انتخاب شده بودند، انجام­ گرفت. ابزار گردآوری داده‌ها شامل: فرم ثبت مشخصات دموگرافیک و بالینی، چک‌لیست بی‌احترامی ­و بدرفتاری حین ­زایمان و پرسشنامه افسردگی پس از زایمان ادینبورگ­ بود که به‌وسیله مصاحبه با شرکت­ کنندگان تکمیل شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار STATA (نسخه 14) و آزمون‌های رگرسیون لجستیک تک­ متغیره و چندگانه انجام­ گرفت. میزان p کمتر از 05/0 معنی­ دار در نظر گرفته شد.
یافته ها: بر اساس نتایج، 235 نفر (2/68%) از شرکت‌کنندگان در مطالعه حداقل یک مورد بی‌احترامی ­و بدرفتاری حین زایمان را تجربه کرده بودند و میانگین نمره کلی آن 3/1±47/1 (دامنه 6-0) بود. شایع­ ترین فرم بی­ احترامی و بدرفتاری تجربه شده توسط زنان، مراقبت بدون­ رضایت (3/59%) و ترک ­مراقبت (9/30%) و کمترین آن در بُعد تبعیض (3/2%) بود. میزان افسردگی پس از زایمان 1/32% بود. بر اساس نتایج آنالیز رگرسیون چندگانه، داشتن تحصیلات دبیرستان (02/0=p) و دانشگاهی (04/0=p) و حمایت بالای همسر (05/0=p) در بروز افسردگی پس از زایمان، نقش پیشگیرانه و داشتن همراه­ زایمانی آموزش ­ندیده (042/0=p)، نداشتن همراه زایمانی (048/0=p) و تجربه بی­احترامی ­و­ بدرفتاری حین ­زایمان (001/0=p)، نقش مؤثری در بروز افسردگی پس از زایمان داشت.
نتیجه­ گیری: ارتقاء سطح مراقبت ­های ارائه ­شده حین زایمان با استفاده از آموزش پرسنل ­مامایی در خصوص اهمیت تکریم مادران و پایش مرتب عملکرد آن‌‎ها، نقش مهمی در پیشگیری از اختلالات روانی بعد از زایمان دارد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The relationship between disrespect and abuse during childbirth with postpartum depression in mothers attending comprehensive health centers in Saqqez city, 2023

نویسندگان [English]

  • Parisa Ebrahimi 1
  • Seyedeh Soma Zakariaee 2
  • Roonak Shahoei 3
  • Leila Hasheminasab 2
1 M.Sc. Student of Midwifery, Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran.
2 Instructor, Department of Midwifery, Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
3 Professor, Department of Midwifery, Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
چکیده [English]

Introduction: Identifying the risk factors for postpartum mental disorders such as depression, given its importance and complications, is a step towards improving maternal health. Therefore, the present study was conducted with aim to determine the relationship between disrespect and abuse during childbirth and postpartum depression.
Methods: This cross-sectional study was conducted in 2023 on 348 eligible mothers attending comprehensive health centers in Saqqez city who were selected by cluster sampling method. Data collection tools included: demographic and clinical profile registration form, Disrespect and Abuse during Childbirth Checklist, and the Edinburgh Postpartum Depression Questionnaire, which were completed through interviewing with the participants. Data analysis was performed using STATA software (version 14) and univariate and multivariate logistic regression tests. P<0.05 was considered significant.
Results: The results showed that 235 (68.2%) of the participants in the study had experienced at least one case of disrespect and mistreatment during childbirth, and the mean overall score was 1.47±1.3 (range 0-6). The most common form of disrespect and mistreatment experienced by women was care without consent (59.3%) and abandonment of care (30.9%), and the least common was discrimination (2.3%). The rate of postpartum depression was 32.1%. The results of multivariate regression analysis showed that having high school (P=0.02) and university (P=0.04) education and high spousal support (P=0.05) played a preventive role in the occurrence of postpartum depression, and having an uneducated birth companion (P=0.042) and not having a birth companion (P=0.048) and experiencing disrespect and abuse during childbirth (P=0.001) played an effective role in the occurrence of postpartum depression.
Conclusion: Improving the level of care provided during childbirth by educating midwifery personnel about the importance of respecting mothers and regularly monitoring their performance plays an important role in preventing postpartum mental disorders.

کلیدواژه‌ها [English]

  • Disrespect and abuse during childbirth
  • Obstetric violence
  • Postpartum depression

مراجع

  1. Safeguarding maternal mental health in the perinatal period. EClinicalMedicine 2024; 71:102663.
  2. Sylvén SM, Thomopoulos TP, Kollia N, Jonsson M, Skalkidou A. Correlates of postpartum depression in first time mothers without previous psychiatric contact. European Psychiatry 2017; 40:4-12.
  3. Segre LS, Davis WN. Postpartum depression and perinatal mood disorders in the DSM. Postpartum Support International 2013; 3:1-6.
  4. Onyewuenyi TL, Peterman K, Zaritsky E, Weintraub ML, Pettway BL, Quesenberry CP, et al. Neighborhood disadvantage, race and ethnicity, and postpartum depression. JAMA Network Open 2023; 6(11):e2342398-.
  5. Govender D, Naidoo S, Taylor M. “I have to provide for another life emotionally, physically and financially”: understanding pregnancy, motherhood and the future aspirations of adolescent mothers in KwaZulu-Natal South, Africa. BMC pregnancy and childbirth 2020; 20:1-21.
  6. Santos DF, Silva RD, Tavares FL, Primo CC, Maciel PM, Souza RS, et al. Prevalence of postpartum depression symptoms and their association with violence: a cross-sectional study, Cariacica, Espírito Santo, Brazil, 2017. Epidemiologia e Serviços de Saúde 2021; 30:e20201064.
  7. Ghanei Gheshlagh R, Mahmoodi H, Baghi V. A comparison of postpartum depression between fathers and mothers in Saqqez. Iranian Journal of Psychiatric Nursing 2015; 3(2):72-9.
  8. Gharacheh M, Ranjbar F, Azadi S. Women’s quality of life and postpartum depression. Iran Journal of Nursing 2018; 30(110):68-77.
  9. Lilhore UK, Dalal S, Varshney N, Sharma YK, Rao KB, Rao VM, et al. Prevalence and risk factors analysis of postpartum depression at early stage using hybrid deep learning model. Scientific reports 2024; 14(1):4533.
  10. Froeliger A, Deneux-Tharaux C, Loussert L, Bouchghoul H, Madar H, Sentilhes L. Prevalence and risk factors for postpartum depression 2 months after a vaginal delivery: a prospective multicenter study. American journal of obstetrics and gynecology 2024; 230(3):S1128-37.
  11. World Health Organization. WHO recommendations on intrapartum care for a positive childbirth experience. World Health Organization; 2018.
  12. Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review. PLoS medicine 2015; 12(6):e1001847.
  13. Freedman LP, Ramsey K, Abuya T, Bellows B, Ndwiga C, Warren CE, et al. Defining disrespect and abuse of women in childbirth: a research, policy and rights agenda. Bulletin of the World Health Organization 2014; 92:915-7.
  14. Bowser D, Hill K. Exploring evidence for disrespect and abuse in facility-based childbirth: report of a landscape analysis. USAID-Traction project 2010.
  15. Siraj A, Teka W, Hebo H. Prevalence of disrespect and abuse during facility based child birth and associated factors, Jimma University Medical Center, Southwest Ethiopia. BMC pregnancy and childbirth 2019; 19:1-9.
  16. Kassa ZY, Tsegaye B, Abeje A. Disrespect and abuse of women during the process of childbirth at health facilities in sub-Saharan Africa: a systematic review and meta-analysis. BMC international health and human rights 2020; 20:1-9.
  17. Leite TH, Pereira AP, do Carmo Leal M, da Silva AA. Disrespect and abuse towards women during childbirth and postpartum depression: findings from Birth in Brazil Study. Journal of affective disorders 2020; 273:391-401.
  18. Tabar JH, Shahoie R, Zaheri F, Mansori K, Nasab LH. Prevalence of disrespect and abuse during childbirth and its related factors in women hospitalized in the postpartum ward. Journal of family medicine and primary care 2023; 12(2):246-52.
  19. Rønnov-Jessen I, Eklund M, Hammer A, O’Connor M, Prinds C, Hvidtjørn D. Parents’ mental health after termination of pregnancy for foetal anomaly–a systematic review. Journal of Reproductive and Infant Psychology 2025; 43(2):338-65.
  20. Montesinos‐Segura R, Urrunaga‐Pastor D, Mendoza‐Chuctaya G, Taype‐Rondan A, Helguero‐Santin LM, Martinez‐Ninanqui FW, et al. Disrespect and abuse during childbirth in fourteen hospitals in nine cities of Peru. International Journal of Gynecology & Obstetrics 2018; 140(2):184-90.
  21. Abuya T, Warren CE, Miller N, Njuki R, Ndwiga C, Maranga A, et al. Exploring the prevalence of disrespect and abuse during childbirth in Kenya. PloS one 2015; 10(4):e0123606.
  22. Ross-Davie MC. Measuring the quantity and quality of midwifery support of women during labour and childbirth: The development and testing of the'Supportive Midwifery in Labour Instrument'. Scotland: University of Stirling; 2012.
  23. Silveira MF, Mesenburg MA, Bertoldi AD, De Mola CL, Bassani DG, Domingues MR, et al. The association between disrespect and abuse of women during childbirth and postpartum depression: Findings from the 2015 Pelotas birth cohort study. Journal of affective disorders 2019; 256:441-7.
  24. Souza KJ, Rattner D, Gubert MB. Institutional violence and quality of service in obstetrics are associated with postpartum depression. Revista de saude publica 2017; 51:69.
  25. Nasiri M. Mental health of pregnancy and childbirth. Tehran: Publication and promotion of Bushra; 2000.
  26. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. The British journal of psychiatry 1987; 150(6):782-6.
  27. Ahmadi kani Golzar A, GoliZadeh Z. Validation of Edinburgh Postpartum Depression Scale (EPDS) for screening postpartum depression in Iran. Iranian Journal of Psychiatric Nursing 2015; 3(3):1-10.
  28. Bekele W, Bayou NB, Garedew MG. Magnitude of disrespectful and abusive care among women during facility-based childbirth in Shambu town, Horro Guduru Wollega zone, Ethiopia. Midwifery 2020; 83:102629.
  29. Ghanbari-Homayi S, Fardiazar Z, Meedya S, Mohammad-Alizadeh-Charandabi S, Asghari-Jafarabadi M, Mohammadi E, et al. Predictors of traumatic birth experience among a group of Iranian primipara women: a cross sectional study. BMC pregnancy and childbirth 2019; 19:1-9.
  30. Lashgaripour K. Postpartum depression and related factors: A 4.5 months study. Journal of Fundamentals of Mental Health 2011; 13(52):404-12.
  31. Ghojazadeh M, Mohamadrezaei Z. Study of relationship between some predisposing factors and postpartum depression. Journal of Ardabil University of Medical Sciences 2008; 8(1):54-61.
  32. Khorramirad A, Lotfi MM, Bidgoli AS. Prevalence of postpartum depression and related factors in Qom. Pajoohandeh Journal 2010; 15(2):62-6.
  33. Vazirinejad R, Sayadi AR, Poor Hasankhani V, Alinejad H, Pakzad H, Shool Z. Relationship Between Midwifery Along With Type of Delivery And The Rate of Anxiety, Stress, And Depression In Primiparous Women Wanting to Give Birth Naturally In Niknafs Hospital of Rafsanjan In 2021. Nursing And Midwifery Journal 2022; 19(10):793-800.
  34. Reed R, Sharman R, Inglis C. Women's descriptions of childbirth trauma relating to care provider actions and interactions-BMC Pregnancy and Childbirth 2017; 17(1):21.
  35. Patterson J, Martin CJ, Karatzias T. Disempowered midwives and traumatised women: Exploring the parallel processes of care provider interaction that contribute to women developing Post Traumatic Stress Disorder (PTSD) post childbirth. Midwifery 2019; 76:21-35.
  36. Martinez-Vázquez S, Hernández-Martínez A, Rodríguez-Almagro J, Delgado-Rodríguez M, Martínez-Galiano JM. Relationship between perceived obstetric violence and the risk of postpartum depression: An observational study. Midwifery 2022; 108:103297.
مجله زنان، مامایی و نازایی ایران
دوره 28، شماره 3
خرداد 1404
صفحه 63-75

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